Urinary drainage apparatus

ABSTRACT

CATHETER FOR INSERTION INTO PATIENT&#39;&#39;S BLADDER CONNECTED TO TUBING WHICH TERMINATES AT A URINE COLLECTION RECEPTACLE. TUBING FOMED OF LIMP MATERIAL SO THAT IT NORMALLY ASSUMES A COLLAPSED CONDITION. PORTION OF CATHETER MAY ALSO BE FORMED OF LIMP MATERIAL, AND STIFF, FLEXIBLE ROD EXTENDS LONGIDUDINALLY ALONG CATHETER BUT IS SEPARABLE FROM IT.

Sept 20, 1971 H. J. HElMLlcH URINARY DRAINAGE APPARATUS 2 Sheets-Sheet 1Filed Nov. 18, 1968 /,f ATTORNEYS INVENTOR Hen/@Y .I /fF/Mz/c# iff/@5.5

Sept. 20, 1971 H. J. HEIMLICH URINARY DRAINAGE APPARATUS 2 SheetsSheet 2Filed Nov. 18, 1968 INVENTOR-l /fewfer J Mf/ML/cf/ ATTORNEYS 3,605,749URINARY DRAINAGE APPARATUS Henry I. Heimlich, 650 Main St., NewRochelle, N .Y. 10801 Filed Nov. 18, 1968, Ser. No. 776,591 Int. Cl.A61m 25/00 U.S. Cl. 12S-349R 9 Claims ABSTRACT F THE DISCLOSURE Catheterfor insertion into patients bladder connected to tubing which terminatesat a urine collection receptacle. Tubing formed of limp material so thatit normally assumes a collapsed condition. Portion of catheter may alsobe formed of limp material, and stiff, fiexib-le rod extendslongitudinally along catheter but is separable from it.

This invention relates to urinary drainage apparatus and moreparticularly to the tubing and catheter forming part of such anapparatus.

A urinary drainage apparatus includes, generally, a catheter forinsertion through the patients urethra into the bladder, a drainagetubing connected at one end to the catheter, and a drainage orcollection bag connected to the other end of the tubing. Since thecatheter is essentially a tube, the catheter and drainage tubing willsometimes be referred to hereinafter by the term tubing. Conventionally,the drainage tubing and catheter are formed of material (eg. rubber orplastic) which is flexible but stiff enough to retain itscross-sectional shape, usually circular, even when no liquid is flowingthrough it. Use of such tubing presents several problems, two of whichstem from the fact that, when the apparatus is in use, the catheter anddrainage tube always remain filled with a column of urine.

The column of urine is formed, and retained, because the only opening inthe tubing is at the end within the patients bladder. Hence, no air canenter the tubing above the column of liquid. The presence of the urinewithin the tubing leads to infection of the bladder, since it remains indirect communication with the urine column. Secondly, the force ofgravity acting upon the column of urine produces a partial vacuum, ornegative pressure, within the bladder causing trauma to the bladdermucosa.

Another problem caused by use of a catheter of relatively stiff materialinvolves the fact that the meatus, or entrance to the urethra,continually rubs against the exterior of the catheter and thus becomesirritated, and consequently susceptible to infection.

In the past, attempts have been made to diminish the incidence ofinfection ascending from the drainage bag to the patient by providingair inlets in the bag, thus breaking the continuity between the urine inthe tubing and in the bag. This expedient, however, does not solve theproblems outlined above since a column of urine remains in the tubing.Furthermore, the mechanism for admitting the air increases the cost ofthe drainage apparatus, and the air admitted may itself causecontamination of the interior of the apparatus and infection of thepatient.

It is an object of the present invention to overcome the problemsoutlined above by providing tubing, for connecting the patient to theurine receptacle, incapable of supporting a column of urine even thoughthe tubing is not provided with any air inlets.

It is another object of the invention to provide such tubing which moveswith the patients urethra, thereby avoiding the troublesome rubbingcontact referred to above.

To accomplish these objectives, the invention employs tubing formed ofmaterial without stiffness, and having a degree of limpness such that itcannot maintain any particular cross-sectional shape, but insteadcollapses when not filled with liquid. A column of urine cannot remainin such a tube, since as the urine enters the tube, the combined forcesof gravity acting on the liquid and air pressure acting on the exteriorof the tubing, cause the urine to flow through the tubing into thedrainage receptacle. Furthermore, such a tube does not have sufiicientstiffness to be self-supporting, and therefore it moves with theurethra. To prevent the tubing from becoming occluded should thepatients leg, or some object, come to rest upon it, a protective sheathof more rigid material may surround the limp tubing. If the catheter isformed of the limp material described above, it may be difiicult toinsert through the urethra. To tavoid this problem, a relatively stiff,but flexible, rod may be separably associated with the catheter, the rodbeing removed after the catheter has been applied to the patient. In thealternative, an outer tubing of stiffer material may surround thecatheter.

Additional objects and advantages of the invention will be apparent fromlthe following description in which reference is made to theaccompanying drawings.

In the drawings:

FIG. 1 is an elevational view of a urinary drainage apparatus, of thetype to` which this invention relates, provided with tubing according tothe invention;

FIG. 2 is a cross-sectional view taken along line 2-2 of FIG. 1, thetubing being shown substantially larger than actual size;

FIG. 3 is a view, partly in cross-section, of a feature of theinvention;

FIG. 4 is a longitudinal cross-sectional view of a catheter according tothis invention;

FIG. 5 is a transverse cross-sectional view taken along line 5 5 of FIG.4;

FIG. 6 is a fragmentary view similar to FIG. 5 showing an alternativecatheter construction; and

FIG. 7 is an elevational view of another embodiment of the invention.

An arrangement chosen to illustrate the present invention, and shown inFIG. 1, includes a catheter 10 connected by means of a fitting 9, to oneend of a drainage tubing 11, the other end of which is connected to adrainage or collection bag 12. The bag 12 is provided with means, suchas a hook 13, for suspending it at a level below the level of thepatient to which it is connected. The end 14 of the catheter 10, whichis inserted through the patients urethra into the bladder, is formedwith an opening 15 in its wall through which urine enters the catheter.The urine fiows through the catheter 10 and tubing 11 into the bag 12.The bag may be furnished with a fitting 16 to which the lower end oftubing 11 is connected, or the tubing 11 and bag 12 may be madeintegral. Within the bag, the fitting 16 can, if desired support aone-way valve 17, such as a flattened, tubular rubber flutter valve, toprevent reverse flow of urine from the bag should the bag inadvertentlybe raised above the patient. Near its bottom, the bag may have an outlettube 18 normally closed by clamp 19. Although a bag 12 has been shown asthe urine collection receptacle, it is understood that any suitablereceptacle may be employed, including a drain. In fact, the receptacleitself forms no part of the present invention.

According to this invention, the drainage tubing 11 (FIGS. 1 and 2) isformed of a limp material, completely without stiffness. As a result,the tubing is unable to sustain, without support, any preselectedcross-sectional shape. Instead, the tubing 11 tends to assume aflattened condition in which its walls 22 and 23 lie against each other(a relatively large spacing being shown between the walls in FIG. 2 forthe sake of clarity). Any suitable material may be used to form thetubing 11. For example, thin polyethylene film of the type used to makeplastic bags in which merchandise is packaged may be employed. Anytendency of the walls 22 and 23 to stick together after their innersurfaces have become wetted with urine can be avoided by making theseinner surfaces rough rather than smooth.

No column of urine can exist in the tubing 11y formed of the materialdescribed above. The reason is that as urine enters the tubing,temporarily separating the walls 22 and 23, it ilows through to the bag12 under the influence of gravity. Although no air is permitted to enterthe tubing from above the urine, a vacuum which might prevent ow of theurine is prevented from forming within the tubing by the collapse of thetube, above the urine, under the inlluence of atmospheric pressureacting upon the exterior of the tubing.

To prevent the tubing 11 from being inadvertently fiattened, and itsinterior occluded, the tubing may be surrounded for some or all of itslength by a sheath 24 (FIG. 3) of stiffer material, such as a suitableplastic. The sheath 24 may be formed of flexible tubing, as long as ithas sutlicient stiffness so that it will not ilatten when, for example,the patient rests his leg on it. The ends of the sheath may be securedto the tubing 11 by bands 25, in which case the sheath is furnished witha hole 26 to permit atmospheric pressure to act on the tubing 11. It thebands 25 are eliminated, or so formed as to leave at least one end ofthe sheath 24 open to the atmosphere, the hole 26 may be eliminated.

A conventional catheter may be employed with the drainage tube 11 ofthis invention, but preferably the catheter is also formed of limpmaterial, as described above, and shown in FIGS. 4 and 5. FIGS. 4 and 5show the catheter on a scale larger than actual size. The catheterincludes a main tube formed by walls 29 and 30 of limp material. Thecatheter illustrated is of the so-called Foley type, having an airpassageway 31 extending longitudinally along the main tube 29, 30. Thepassageway 31 terminates at one end in an inflatable balloon portion 32,and at its other end in a titting 33 containing a valve. As is wellknown, the fitting is adapted to accommodate the end of a hypodermicsyringe or needle, and after the end 14 of the catheter has beeninserted into the patients bladder, operation of the syringe causes airto pass through passageway 31 into portion 32 whereby the latter becomesdistended. The resultant enlargement on the end of the catheter withinthe bladder prevents accidental withdrawal of the catheter.

A catheter formed completely of limp material lacks suiiicient stiffnessto enable its ready insertion through the urethra into the bladder.Therefore, the present invention provides means for stiffening thecatheter. In the embodiment of FIGS. 4 and 5, the stiifening meansincludes a still, but flexible, rod or stylet 36 accommodated within achannel or pocket 37 extending longitudinally along the main tube of thecatheter. After the catheter has been inserted into its position of use,the rod 36 may be removed by grasping its handle 38 and pulling it outof the pocket 37. If desired, the pocket 37 could be eliminated and therod 36 carried within the passageway 31, the rod being removable afterthe catheter is positioned for use. Alternatively, the pocket 37 couldbe made solid to give the catheter suflicient lirmness to allow itsinsertion.

Another problem presented by a catheter formed cornpletely of limpmaterial is that it is susceptible to being flattened, and its interioroccluded, by the prostate gland of male patients. This can be avoided byforming the catheter portion 39 adjacent to the end 14 of a stiffermaterial, such as the material of which conventional catheters are made.However, the portion 39 should be short enough so that it does not reachthe exterior opening to the patients urethra. Consequently, the portionof the catheter passing through the urethra opening will be limp, andtherefore will move with, rather than rub against, the opening, therebyavoiding irritation and possible infection of the patient.

The embodiment of the catheter illustrated in FIG. 6 presents anotherway of providing sufficient stillness for insertion of the catheter, andpreventing occlusion of the catheter within the patients body. The maintube 42 of the catheter is formed of limp material, as described above,and extends from directly behind the opening 15', at the forward end 14of the catheter, along the length of the catheter. Surrounding the maintube 42 is an outer tubing 43, which may be of the same stiffness asconventional catheters. The outer tubing is formed with a hole 44through which atmospheric pressure acts on the tube 42, or in thealternative, the end of the tube 43 remote from the forward end 14 maybe open to the atmosphere.

As illustrated in FIG. 7, the invention also contemplates that thecatheter 10 and drainage tube 11 may be formed as a single, integralunit 46 of limp material. In FIG. 7, parts similar to those in FIG. 4have been given the same reference numeral followed by a double prime.

The invention has been shown and described in preferred form only, andby way of example, and it is understood therefore, that many variationsmay be made in the invention which will still be comprised within itsspirit.

What is claimed is:

1. For use with a urinary drainage receptacle intended to receive urinefrom a patient, a tubing for draining urine from a patients bladder,said tubing having an interior adapted to communicate with the interiorof the drainage receptacle and means at one end to permit introductionof urine into said tubing, at least a portion of the length of saidtubing being formed of material having a degree of limpness such thatsaid tubing portion is not self-supporting and cannot by itself maintainany preselected cross-sectional shape and therefore normally assumes adat collapsed condition in which its Walls lie against each other acrossan entire transverse dimension of said tubing, whereby urine enteringsaid tubing at the patients bladder will ilow through said limp tubingportion to the drainage receptacle and will not remain as a column ofliquid in said limp portion despite the fact that air may not enter thetubing between said limp portion and the bladder, and an outer sheathresistant to radial compression surrounding at least a portion of thelength of said limp tubing portion, said tubing being devoid of meansfor permitting iuid flow communication between the interiors of saidtubing and sheath, whereby uid external to said sheath cannot flow fromthe interior of said sheath into said tubing.

2. A tubing as deiined in claim 1 wherein said tubing includes adrainage tube connected to the drainage receptacle, and a catheterconnected to said drainage tube and adapted to pass through the patientsurethra.

3. A tubing as deiined in claim 2 wherein only said drainage tube isformed of said limp material.

4. A tubing as defined in claim 2 wherein said drainage tube andcatheter are both formed of said limp material.

S. A tubing as defined in claim 4 wherein the portion of said catheteradjacent to the end which enters the patients bladder is formed of amaterial stiffer than said limp material.

6. A tubing as defined in claim 4 including a rod of stiff ilexiblematerial, and means for separably hold ing said rod alongside saidcatheter, said rod giving said catheter suicient stiffness to beinserted through the patients urethra into the bladder.

7 A tubing as defined in claim 4 wherein said catheter and drainage tubeare integral.

8. A urinary drainage catheter for draining urine from a patientsbladder, comprising a length of tubular ma terial having a degree oflimpness such that it is not self-supporting and cannot by itselfmaintain any preselected cross-sectional shape and therefore normallyassumes a at collapsed condition in which its walls lie against eachother, said tubular material having means at one end to permitintroduction of urine into said tubing, and means extendinglongitudinally along said length of tubular material for providing thelatter with suicient stitness to permit insertion of the catheter into apatents bladder, said stlening means including an outer sheath resistantto radial compression surrounding at least a portion of the length ofsaid limp tubular material, said tubular material being devoid of meansfor permitting uid flow communication between the interiors of saidtubular material and sheath, whereby uid external to said sheath cannotow from the interior of said sheath into said tubular material.

9. A catheter as dened in claim 8 wherein a portion of said catheteradjacent to the end which enters the patients bladder is formed of amaterial stiier than said limp material, said stiier portion being shortenough so as not to reach the exterior opening to the patients urethrawhen the catheter is in use.

References Cited UNITED STATES PATENTS 319,937 `6/1885 Sutton 12S-231397,256 2/ 1889 Sutton 12S-240 1,596,754 8/1926 Moschelle 12S-3502,749,913 6/1956 Wallace 12S-350 2,850,015 9/ 1958 Baxter 12S-2273,169,528 2/1965 Knox et al. 128--350 3,307,549 3/ 1967 Zackheim 128-2273,384,089 5/1968 Shriner 128-350 3,398,743 S/1968 Shalit 12S-2313,406,691 10/ 1968 Kettenbach 128--350 3,428,046 2/1969 Remer et Ial.128-349 3,168,092 2./ 1965 Silverman 12S- 262x 3,419,009 12/1968 Ericson128-349 FOREIGN PATENTS y1,211,941 10/1959 IFrance 12S-214.4

DALTON L. TRULUCK, Primary Examiner U.S. Cl. X.R. 128--295

